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The effects of low testosterone, or low T, can extend beyond a low sex drive and other sexual symptoms to behavioral and emotional effects as well.

In some men, the condition leads to depression, says researcher Mohamed Kabbaj, PhD, an associate professor in biomedical sciences and neurosciences at the Florida State University College of Medicine in Tallahassee, and "in these individuals, replacement with testosterone leads to improvement in the symptoms of depression.”

Research done by Kabbaj and colleagues using lab animals was the first to suggest a biological mechanism for this effect, revealing a pathway in the hippocampus affected by testosterone. Their study, published in "Biological Psychiatry," found that depression in neutered male rats, likely caused by the drop in testosterone in their system, is reversed with testosterone treatment. The finding suggests that hormone replacement therapy has the potential to reverse depression as well as address some of the other symptoms of low testosterone in men, such as low sex drive and trouble sleeping. Additionally, says Kabbaj, the research suggests that having enough testosterone in your system strengthens the effects of any tricyclic antidepressants you’re taking for depression.

Hormone Replacement Therapy in the Real World

The research confirms what some doctors have found in their day-to-day practices. “Men with low testosterone have decreased exercise tolerance, fatigue, loss of energy, and sleep disturbance," says Stanley Korenman, MD, an endocrinologist on the faculty at the University of California, Los Angeles. "They also complain of decreased ability to concentrate and then sexual dysfunction -- the exact symptoms associated with depression.”.

Dr. Korenman has heard these concerns from thousands of men over the quarter century that he’s been practicing. “I think that low-T does depress mood," he says. "Treatment with testosterone does improve mood, and there are multiple ways of interpreting that.”

Despite the magic bullet quality that testosterone could have in treating depression, testosterone replacement is not Korenman’s go-to treatment for depression, particularly in young men.

“If they are interested in fertility -- not necessarily immediately, but within two or three years -- then I treat with antidepressants because, if you treat with testosterone, you’ll suppress their ability to be fertile,” he explains. In men for whom testosterone and depression are related, he’s found that just treating the depression can allow testosterone to come back up to normal levels. This is especially helpful, Korenman says, if the depression treatment is combined with a healthy diet, a healthy weight, exercise, and sound sleep -- all of which can help you make the testosterone you needs naturally.

The bottom line is that if you are struggling with depression, talk to your doctor about a hormone panel or blood test to find out if you have low testosterone. Then, based on your age and family goals, you can decide if trying testosterone replacement along with antidepressants makes sense for you.

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